Better together? Ambulance staff views of human factors in resuscitation

Abstract

Background Research into the care of cardiac arrest patients outside of hospital is limited. Evidence from hospital settings suggests that human factors including both technical and non-technical skills and performance may impact on care. This study sought staff views from a UK ambulance service aiming to investigate areas for improvement in resuscitation performance. Methods Volunteer ambulance staff responded to an open invitation to complete an anonymous internet-based survey. The survey used a mixture of closed questions, Likert-scaled answers and free text to explore staff views on resuscitation performance. Quantitative responses were presented graphically, and free text answers arranged by theme. Results 111 staff responded to the survey. The results demonstrated that staff see effective teamwork as desirable in out-of-hospital resuscitation, but that this is not always the case currently. Staff felt more confident about practical skills such as cannulation and chest compression delivery. Difficulties were noted in: poor communication between staff members; inconsistent identification and nomination of leaders; low staff confidence in peri- and post-cardiac arrest conversations with relatives; and insufficient staff numbers on scene. Conclusions The findings demonstrate poor staff confidence in several non-technical skills, including teamwork and communication. Limitations of the survey included lack of recording of training received—where this has shifted in recent years from in-service to higher education routes—and missing demographic data. However, the findings provide specific areas for improvement activity. This has already included best practice slides displayed in ambulance stations, and proposals for identification wristbands, a role-based work standard to reduce task omission and duplication, and a policy to send higher numbers of rescuers to cardiac arrest cases. https://emj.bmj.com/content/32/6/e14.2. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ DOI http://dx.doi.org/10.1136/emermed-2015-204980.8